Presented to the VCACC Council on November 18, 2023
ACC Legislative Conference 2023
ACC Health Affairs Committee
Supported 5 legislative initiatives
INCREASING PATIENT ACCESS TO CARE
1) HR 2474 Strengthening Medicare for Patients and Providers ACT
PROTECTING CLINICIAN WELL-BEING AND WORKFORCE
2) HR 4968 Getting Over Lengthy Delays in Care As Required by Doctors (Gold Card) Act
3) HR 2583 Increasing Access to Quality Cardiac Rehabilitation Care Act
IMPROVING HEART HEALTH FOR ALL
4) HR 2370/S1024 Access to AEDs Act
5) HR 4261 Amputation Reduction and Compassion (ARC) Act
SPECIFIC BILLS
1) HR 2474 Strengthening Medicare for Patients and Providers ACT
An important step in long term Medicare payment reform
Bill provides an annual inflationary update to the Medicare Physician Fee Schedule equal to the Medicare Economic Index.
Current:
2024 - CMS projects Medicare Economic Index increase 4.5%
2024 - Providers face 3.36% reduction in Medicare Physician Fee Schedule reimbursement
Over the past 20 years:
The cost of running a physician practice (small business) has increased 47% (2001-2023).
Medicare reimbursement has decreased by 26% accounting for inflation over the same period.
Payment uncertainty and payment reductions create pt access issues that disproportionately impact people of color and patients in underserved communities.
1a) Budget Neutrality - PAYGO
Draft legislation proposalHouse Energy Finance Committee
Increase PAYGO budget neutrality threshold
Current:
Budget neutrality threshold $20 million
1989 Statute - Any changes made to Medicare fee schedule payments need to be implemented in budget neutral manner.
If CMS projects net pricing increase for existing services greater than this threshold, CMS must reduce all Medicare physician reimbursement by that excess amount (adjustment in conversion factor). Note, congress last year delayed these cuts (until 2024) thus averting a $38 billion reimbursement reduction in 2023.
Payment uncertainty and payment reductions create pt access issues that disproportionately impact people of color and patients in underserved communities.
2) HR 4968 Getting Over Lengthy Delays in Care As Required by Doctors (Gold Card) Act
This bill will allow clinicians who meet prior authorization requirements 90% of the time to be exempt from such requirements for a specified period.
Current:
The prior authorization process is a burdensome, time and resource consuming process, resulting delays in care that can result in severe adverse patient events and contribute to provider burnout.
3) HR 2583 Increasing Access to Quality Cardiac Rehabilitation Care Act
This bill will allow advanced practice providers (physician assistants, nurse practitioners, and Certified Nurse Specialist) to order cardiovascular and pulmonary rehabilitation services within Medicare.This will help to facilitate timely referrals for services that have been proven to improve patient health and reduce future healthcare costs.(26% lower CV related death, 18% lower 1yr readmission).
Current:
Of note, a prior bill allows these same providers, as of 1/2024, to supervise rehabilitation services.
Access disproportionately impacts people of color and patients in underserved communities. 42% lower pt participation in economically deprived urban area
4) HR 2370/S1024 Access to AEDs Act
This bill will establish a federal grant program for elementary and secondary schools to provide access to automated external defibrillators (AEDs) and necessary associated education and training.This act also adheres to best practices by ensuring student heart health screening programs are developed in accordance with American College of Cardiology and American Heart Association guidelines. Cost should not be a barrier to schools that want to make AEDs available
Current:
Not all schools have AEDs or provide adequate training and education
Staff, community members, and organizations also frequent schools
Cost barriers disproportionately impact schools in underserved communities
5) HR 4261 Amputation Reduction and Compassion (ARC) Act
This bill aims to reduce preventable limb amputations associated with peripheral artery disease by covering screening studies. Estimates 50-80% amputations avoidable. 400+ pts per day.
Current:
The disease process can often go unrecognized until advanced disease is present.
When peripheral artery disease is diagnosed early and treated, amputation is commonly avoided.
Peripheral artery disease disproportionately impacts woman, people of color, and patients in underserved communities.
No amputation - no complications, no disability
Thank you to VCACC legislative delegation
Michael Ayers, MD, FACC
Rachel Barish, NP
Chris Kramer, MD, FACC
Linda Hart, DNP, RN, ACNP-BC, FACC
Jacob McAuliffe, MD, IM Chief Resident
Conner Oats, MD FIT
Evan Ownby, MD, FACC
Victor Soukoulis, MD, PhD, FACC
George Vetrovec, MD, MACC
Lauren Prestera, ACC Staff - Guidelines
Jessica Steinberg, MBA, ACC Staff - Global Programs
ACC Legislative Advocacy - Get involved!
Sign up for Grassroot Action Alerts: Email Meg Novak mnovak@acc.org to sign up
Participate in the ACC Legislative Conference- Fun few days! September 29-October 1, 2024, Washington, DC
Join HeartPac- Not as much fun, but supports legislators who support ACC causes
Save the date for ACC's Legislative Conference 2024, taking place from September 29 - October 1, 2024 in Washington, DC! This signature three-day event offers cardiovascular clinicians spanning the entire care team a chance to hear from ACC leaders, staff and other experts on health policy issues affecting patients and the profession. It also provides an important opportunity to speak directly with members of Congress and their staff on the final day of the meeting.
Virginia Chapter of the American College of Cardiology
